NPIMap

Organization Active NPI

Mount Vernon Medical Practice

  • General Practice Physician
  • Mount Vernon, NY
National Provider Identifier
1740596741
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
192587 Issued in NY
Legal business name
MOUNT VERNON MEDICAL PRACTICE
Practice address
153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Phone
(914) 666-1400
Fax
(914) 666-0629
NPI assigned
Aug 27, 2010
Last updated
Aug 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Christopher O Adubor, MDNPI 1962464594
Title
President
Phone
(914) 666-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 192587 NY Primary

Addresses

Primary practice location

153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543

Mailing address

153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Phone (914) 666-1400

Other identifiers 1

IdentifierTypeStateIssuer
01605527MedicaidNY

Other names 1

  • Christopher Adubor PC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Mount Vernon Medical Practice4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1740596741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 STEVENS AVE",
            "address_2": "SUITE 4",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502543",
            "telephone_number": "914-666-1400",
            "fax_number": "914-666-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 STEVENS AVE",
            "address_2": "SUITE 4",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502543",
            "telephone_number": "914-666-1400",
            "fax_number": "914-666-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT VERNON MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-27",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "ADUBOR",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-666-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "192587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01605527",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christopher Adubor PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.